Provider Demographics
NPI:1518230440
Name:HUYNH, TAO C (RPH)
Entity Type:Individual
Prefix:
First Name:TAO
Middle Name:C
Last Name:HUYNH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4620 BLACK HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:MAYS LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:08330-3213
Mailing Address - Country:US
Mailing Address - Phone:609-625-4411
Mailing Address - Fax:609-625-7049
Practice Address - Street 1:4620 BLACK HORSE PIKE
Practice Address - Street 2:
Practice Address - City:MAYS LANDING
Practice Address - State:NJ
Practice Address - Zip Code:08330-3213
Practice Address - Country:US
Practice Address - Phone:609-625-4411
Practice Address - Fax:609-625-7049
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02774200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist